title: Working hours, occupational stress and depression among physicians.
abstract: BACKGROUND
  Physicians report high prevalence of depression, work long hours and are exposed to many occupational stresses (OSs).
  
  
  OBJECTIVE
  To investigate the cross-sectional association between working hours, OS and depression among physicians.
  
  
  METHODS
  A self-administered questionnaire was mailed to 1902 alumni of a medical school. The questionnaire evaluated working hours in the previous week, OS assessed by the effort-reward imbalance model, social support and depression evaluated by the Center for Epidemiologic Studies Depression scale. The associations between these occupational factors and depression were analyzed using multiple logistic regression.
  
  
  RESULTS
  The questionnaire was returned by 795 alumni (response rate, 42%), and 706 respondents (534 men and 172 women) were suitable for analysis. The odds ratio (OR) of depression in the long working hours group (>70 h/week) was 1.8 (95% CI: 1.1-2.8) compared with the short working hours group (<54 h/week), adjusted for basic attributes. The adjusted ORs of depression in the upper effort-reward ratio (ERR) tertile versus the lower ERR tertile were 0.6 (0.2-1.8) in the short working hours group, 8.5 (3.0-24.0) in the middle working hours group and 9.9 (3.8-25.7) in the long working hours group. The adjusted ORs of depression stratified according to working hours and ERR tended to be higher in the groups with a higher ERR, but no association between working hours and depression was found.
  
  
  CONCLUSIONS
  This study indicates that the management of OS is needed as a countermeasure against depression among physicians.
authors.affiliation: Department of Community Health and Epidemiology, Nara Medical University School of Medicine, 840 Shijo-cho, Kashihara, Nara 634-8521, Japan. tkimiko@naramed-u.ac.jp
authors.forename: K
authors.initials: K
authors.lastname: Tomioka
authors.forename: N
authors.initials: N
authors.lastname: Morita
authors.forename: K
authors.initials: K
authors.lastname: Saeki
authors.forename: N
authors.initials: N
authors.lastname: Okamoto
authors.forename: N
authors.initials: N
authors.lastname: Kurumatani
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology* / Q000523:psychology; D010820:Physicians / Q000523:psychology* / Q000706:statistics & numerical data; D015995:Prevalence; D012577:Schools, Medical; D013315:Stress, Psychological / Q000453:epidemiology* / Q000209:etiology; D011795:Surveys and Questionnaires; D016526:Workload / Q000523:psychology / Q000706:statistics & numerical data